ObjectiveTo explore the clinical effect of LuX-Valve implantation in patients with severe tricuspid regurgitation (TR) and review articles about similar devices.MethodsWe reported the data of a 58-year-old male patient with severe TR, who was hospitalized on March 17th, 2020 because of “abdominal distention and edema for 5 years”, and then received LuX-Valve implantation in the Department of Cardiovascular Surgery of Changhai Hospital, Naval Medical University. Articles about transcatheter tricuspid valve replacement were reviewed in PubMed according to the key words including “transcatheter tricuspid valve replacement” “TTVR” and “transcatheter tricuspid valve intervention”.ResultsThe patient with severe TR received LuX-Valve implantation under general anesthesia and the guidance of digital subtraction angiography and transesophageal echocardiography. The patient’s TR was totally corrected after implantation and postoperative one-month follow-up showed well clinical effects. The result of literature review showed that there were two similar devices and both had been implanted in TR patients.ConclusionLuX-Valve is an effective and reliable transcatheter tricuspid valve replacement device.
Objective To assess the effectiveness and safety of Shenfutuodu capsule in the treatment of opioid withdrawal syndrome. Methods We searched The Cochrane Library （Issue 1 , 2005 ） , MEDLINE （1966 -2005） , EMBASE （1974-2005） , and some Chinese databases for additional articles （CBMdisc, CMCC, VIP, CNKI ） （1980-2005 ）. The quality of included randomized controlled trials was evaluated and meta-analysis was performed.Results Our initial search identified just three studies involving 293 patients met the inclusion criteria and were of higher quality. There was a statistical difference between Shenfutuodu capsule and clonidine groups on the fifth day in withdrawl symptom score with weight mean difference （WMD） -3.14 and 95% confidence interval （CI） -6.28 to -0.01. And no statistical difference was detected between the two groups in withdrawal symptom score on the 0th-4th day and the 6th-10th daywith WMD 58.45（95% CI 53.88 to 63.02）, -1. 15 （95% CI -5.69 to 3.40） , -0.42（95% CI -4.55 to 3.70）, -0.77（95%CI -4.37 to 2. 84）, -1.54（95%CI -4.78 to 1.69）, -1.76（95%CI -4.25 to0.74） , -1.74（95%CI -3.89 to0.41）, -1.24（95%CI -3.28 to0.80）, -0.52（95%CI -1.96 to0.92 ） and -0.27（95% CI -1.64 to 1.11 ） respectively. There was no statistical difference on effectiveness between the two groups on the third day with WMD 1.52, （95% CI 0.79 to 2.95）. There was no statistical difference between the two groups in HAMA score on the first , fifth and tenth day with WMD -0.55（95% CI -3.74 to 2.64） , 0.34 （95% CI -2.02 to 2.70） , 0. 63 （95% CI -0.21 to 1.47 ） respectively. There was a statistical difference between the two groups in dizziness rate with RR 0.73 （95% CI 0.62 to 0.87 ） . No statistical difference was detected between the two groups in dry mouth with RR 1.11（95% CI 0.95 to 1.29） , somnolence with RR 0.99（95% CI 0.82 to 1.21） , and blurred vision with RR 0.92（95% CI 0.70 to 1.19）. Statistical difference was detected between the two groups in side effect score on the second day with WMD -1.26 （95% CI -2.40 to -0. 12 ）. No statistical difference was detected between the two groups in side effect score on the first day, the third to tenth day with WMD -0.55 （ 95% CI -1.48 to0.38）, -0.63 （95%CI -1.67 to0.42）, -0.84 （95%CI -1.77 to0.09）, -0.29 （95%CI -1.09 to 0.51）, 0.15 （95% CI -0.52 to 0.81）, 0. 22 （95% CI -0.22 to 0.67）, 0.09（95% CI -0.25 to 0.44）, 0.03 （95% CI -0.21 to 0.27） , -0.03 （95% CI -0.33 to 0.26） respectively. Conclusions Based on the current evidence, Shenfutuodu capsule may be an effective and safe drug or abstinence of drug addiction. More well designed randomized controlled trials are required .
ObjectiveTo systematically review the efficacy and safety of roflumilast for patients with chronic obstructive pulmonary disease (COPD). MethodsWe searched PubMed, Web of Science, SpringerLink, Ovid, ClinicalTrials.gov, CBM, WanFang Data and CJFD to collect randomized control trials (RCTs) of roflumilast for COPD patients from inception to December 2014. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 10 RCTs were included. The results of meta-analysis showed that. Roflumilast could significantly improve trough FEV1 (WMD=54.82, 95%CI 46.36 to 63.28, P<0.000 01), and other spirometric parameters; Roflumilast could reduce the exacerbation rate (RR=0.84, 95%CI 0.75 to 0.94, P<0.000 01), and improve TDI score (WMD=0.23, 95%CI 0.04 to 0.42, P=0.002), but did not improve SGRQ score (WMD=-0.48, 95%CI -2.39 to 1.43, P=0.63); Roflumilast could increase some adverse events including diarrhea, headache, nausea, and weight loss. ConclusionCurrent evidence shows roflumilast could significantly improve pulmonary function, reduce the mean exacerbation rate in COPD patients, and has good safety.
ObjectiveTo systematically review the efficacy and safety of Heluo Shugan capsule in the treatment of hepatitis B fibrosis. MethodWe searched PubMed, The Cochrane Library (Issue 8, 2015), CBM, CNKI, VIP and WanFang Data from their inception to August 2015, to collect randomized controlled trials (RCTs) on Heluo Shugan capsule for hepatitis B fibrosis. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. ResultsA total of 15 RCTs involving 1 840 patients were included. The results of meta-analysis showed that: (1) As for reduced level of serum hyaluronic acid (HA), Heluo Shugan capsule was superior to placebo (MD=82.31, 95%CI 37.44 to 127.19, P=0.000 3), but worse than Fuzheng Huayu capsule (MD=-137.45, 95% CI-196.29 to-78.62, P < 0.000 01), Fufang Biejia Ruangan tablet (MD=-51.19, 95% CI-67.58 to-34.81, P < 0.000 01) and Anti-fibrosis decoction (MD=-82.13, 95% CI-102.37 to-61.88, P < 0.000 01). (2) As for reduced level of serum laminin (LN), Heluo Shugan capsule was superior to placebo (MD=36.83, 95% CI 11.84 to 61.82, P=0.004), but worse than Fufang Biejia Ruangan tablet (MD=-36.00, 95% CI-64.29 to-7.71, P=0.01), Ganfujian capsule (MD=-22.14, 95% CI-37.28 to-7.00, P=0.004) and Anti-fibrosis decoction (MD=-38.64, 95% CI-75.00 to-2.29, P=0.04). (3) As for reduced level of serum procollagen type III peptide (PCIII), Heluo Shugan capsule was superior to placebo (MD=47.17, 95% CI 32.68 to 61.66, P < 0.000 01), but worse than Fuzheng Huayu capsule (MD=-4.80, 95% CI-9.08 to-0.51, P=0.03), Dahuang Zhechong pills (MD=-53.77, 95% CI-105.01 to-2.53, P=0.04), Ganfujian capsule (MD=-46.82, 95% CI-66.30 to-27.34, P < 0.000 01) and Anti-fibrosis decoction (MD=-28.68, 95% CI-55.59 to-1.77, P=0.04). (4) As for reduced level of serum type-IV-collagen (IV-C), Heluo Shugan capsule was superior to placebo (MD=72.77, 95% CI 47.65 to 97.89, P < 0.000 01), but worse than Fuzheng Huayu capsule (MD=-34.69, 95% CI-56.65 to-12.73, P=0.002), Dahuang Zhechong pills (MD=-21.26, 95%CI-38.79 to-3.73, P=0.02), Fufang Biejia Ruangan tablet (MD=-69.04, 95%CI-124.38 to-13.69, P=0.01), Ganfujian capsule (MD=-19.84, 95% CI-37.41 to-2.27, P=0.03) and Anti-fibrosis decoction (MD=-37.98, 95% CI-72.99 to-2.96, P=0.03). ConclusionCurrent evidence shows that, Heluo Shugan capsule was superior to placebo, but worse than Fufang Biejia Ruangan tablet, Fuzheng Huayu capsule, Dahuang Zhechong pills, Ganfujian capsule and Anti-fibrosis decoction in reducing the level of serum hepatic fibrosis. Due to the limited quantity and quality of included studies, more high-quality, large-scale RCTs are need to verify the above conclusion.
Objective To assess the efficiency of iodised salt on iodine deficiency disorders. Methods we searched MEDLINE (1996 to December 2009), EMbase (1974 to December 2009), The Cochrane Library (Issue 4, 2009), Current Controlled Trials, The National Research Register, CBM (1983 to December 2009) and CNKI (1994 to December 2009), and traced the literature of the reference. The included objects were the resident of the iodine deficiency area and the age, the race. The sex was not limited. The fortified salt and the iodized salt effects were compared and the research quality was evaluated. Meta-analyses were conducted by the RevMan5.0 software. Results Eight studies involving 1 503 people were included. The goiter prevalence of the fortified salt which combined iodine with iron was lower than that of iodised salt [MD=1.22, 95%CI (0.90, 1.54)]. So was the thyroid gland volume [OR=1.88, 95%CI(1.01, 3.47)]. But the fortified salt which combined iodine with VA did not show this. Conclusion The fortified salt and the iodized salt can obviously improve the iodine nutritional status of people. The fortified salt has enhanced the effect while the iodized salt prevents iodine deficiency disorders, but more high grade randomized controlled trials are needed to confirm this.
ObjectiveTo systematically review the clinical value of ultrasonographic elastography (UE) for the differential diagnosis of benign/malignant thyroid nodules. MethodsWe comprehensively searched the databases including The Cochrane Library (Issue2, 2013), PubMed, EMbase, CNKI, WanFang Data, Medalink, VIP and CBM from inception to the December of 2013, for including clinical research reports of determining thyroid nodules using ultrasonographic elastography. Literature screening according to the inclusion and exclusion criteria, data extraction and methodological quality assessment were completed by two reviewers independently. Then Meta-DiSc software (version 1.4) was used for pooling analysis. ResultsA total of 35 studies including 4 127 patients were included. The results of metaanalysis showed that, specificity, sensitivity, positive likelihood radio, negative likelihood radio and diagnostic odds ratio (DOR) were 0.89 (0.88 to 0.90), 0.88 (0.86 to 0.90), 6.37 (5.44 to7.47), 0.13 (0.11 to 0.16) and 58.72 (43.12 to 79.98), respectively; and the area under SROC curve (AUC) was 0.936 9. ConclusionCurrent evidence shows that ultrasonographic elastography has fairly high sensitivity (88%) and specificity (89%) in differential diagnosis of benign/malignant thyroid nodules. The positive rate in the malignant thyroid group is 58.72 times higher that in benign thyroid cancer with better efficacy in differential diagnosis, so ultrasonographic elastography is of effective and feasible diagnostic value for thyroid benign/malignant nodules.
Objective To systematically review the current situation of health economics evaluation of gastric cancer screening. Methods The PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect the health economics evaluation studies on gastric cancer screening from January 1st, 1975 to September 30th, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Then, qualitative analysis was performed. Results A total of 44 studies were included. Most of the targeted populations of the study were high-risk groups in areas with a high incidence of gastric cancer. Screening methods such as endoscopy and Helicobacter pylori infection detection were mainly evaluated in those studies. According to the results, about 47% of the studies evaluated a single screening method. A total of 35 studies showed that they established models, however, only a few calibrated the models. Conclusion Most studies of gastric cancer screening reviews neither calibrate the results nor consider the effect of smoking on the progression of gastric cancer. Those evaluated screening programs are limited.
The incidence of complications after radical resection of esophageal carcinoma is high up to about 20%-50%. The incidence of pneumonia, pleural effusion, tracheal intubation, anastomotic fistula and cardiac events is relatively high. Among them, pulmonary complications are the most common complications after esophageal cancer operation and cause the most perioperative deaths. Among the factors that influence the occurrence of postoperative complications of esophageal cancer, the amount of fluid infusion during and after the operation is closely related to the occurrence of postoperative complications. Moreover, in the environment of enhanced recovery after surgery (ERAS), it is more important to optimize the postoperative fluid management of esophageal cancer. Restricted fluid therapy plays a more and more important role in patients undergoing esophagectomy. This review integrated the relevant research results and discussed the advantages of the restricted fluid therapy compared with other fluid therapy, how to control the restricted infusion volume and infusion speed and how to monitor and evaluate the infusion process and the selection of infusion types, so as to provide reference for clinical practice test.
ObjectiveTo analyze research status of influencing factors related to sun-protection problems in children and adolescents, and systematically review the influencing factors. MethodsWe electronically searched the following databases including The Cochrane Library, PubMed, Web of Knowledge, Ovid, EBSCO, EMbase, CBM, CNKI, VIP and WanFang Data to collect cross-sectional studies on sun-protection problems in children and adolescents up to December 2012. The criteria for cross-sectional studies recommended by AHQR was applied in the assessment of included studies. Then, qualitative analysis methods were used to systematically summarize information and results of the included studies. ResultsA total of 10 studies were included. The results showed that, the influencing factors of sun-protection behaviour in children and adolescents included gender, age, skin colour, eye colour, the mass media information, school health education, etc., of which, researches on gender, grade, light skin, eye colour were relatively more. ConclusionAt present, there are many studies about influencing factors related to sun-protection problems in children and adolescents while the target influencing factors differ in regions.